Congratulations! You have a new baby and now it’s time to add the little bundle of joy to your Covered California health plan. Unfortunately, similar to other quirks of the Covered California system, adding a new dependent, if not done properly, could result in a gap in coverage for the baby or loss of the […]
Archives for May 2014
Supporting agents to help their clients
Agents and brokers drove in 39% of the enrollments for Covered California during the 2013-14 ACA open enrollment period with the least amount of training and resources of any group submitting applications. As Covered California starts their budget process allocating money for 2014 training, I had to speak publicly at a Board meeting and plead […]
Medicare more expensive than new ACA plans
Individuals who recently acquired Parts A and Part B of Original Medicare may find they have to pay more per month than their existing ACA health plans. Under the ACA rules, once someone accepts Medicare, they must exit any ACA health plan they purchased through the exchange and the tax credits that make it affordable. […]
Covered California surveys agent experience
Did you get your Covered California agent survey and how did you respond? It was a pleasant surprise that a survey from Covered California showed up in my email in-box. Does this survey represent a new chapter in communications between agents and the California exchange or will Covered California continue business as usual with the […]
New ACA plans increase out of network costs to patients
The first challenges individuals and families faced with the smaller provider networks offered in California was keeping their current physician or finding doctors that would accept the new health plans for health care treatment. The next hurdle has been doctors referring or using out of network physicians for patient care. Patients are now getting slapped […]
How to report partial income for ACA enrollment
The Affordable Care Act (ACA) allows for Special Enrollment Periods for individuals and families to purchase a health plan through the federal or a state exchange when there is a loss of coverage from a qualifying such as a change in employment. There has been confusion over how to characterize the previous month’s employment wages […]
Covered California COBRA SEP Cautions
Covered California announced on May 15, 2014 that they will follow the HHS guidance and offer a Special Enrollment Period (SEP) for individuals and families currently on a COBRA health plan. However, people should be cautious before they leave their COBRA plan and jump into a Covered California plan for many reasons.
Is there a Covered California Agent Commission Crisis?
Through casual conversation and on various Internet forums numerous agents and brokers have mentioned they arent getting paid commissions for business they submitted through Covered California. Is there a crisis of commissions not being paid to Certified Insurance Agents? Without reliable data from the agent community it is hard to tell if the missing commissions […]
New Anthem Blue Cross EPO member cards
Anthem Blue Cross of California announced that they are shipping new and improved membership cards for individuals and families in the Exclusive Provider Organization (EPO) health plans in California. The new cards will have the very important three little letters of EPO actually imprinted on the card.
Expanded Medi-Cal costs $611 per member per month
Medi-Cal health insurance premiums paid to managed care health plans or Health Maintenance Organizations (HMOs) is a sizeable sum of money. The California Department of Health Care Services estimates the average monthly cost for each Medi-Cal beneficiary is $611. Expanded Medicaid, where families earning less than 138% of the federal poverty line are automatically enrolled in Medi-Cal through Covered California, encompasses a population who is often healthier and use fewer health care services than beneficiaries who qualified under the original Medi-Cal rules.